This is an application to support the Hawthorne Conference on Office-Based Surgery to be held November 16-17, 2001 entitled " Benefits and Risks of Office-Based Surgery: Special Emphasis on Dermatologic Procedures" at the Hawthorne Inn & Conference Center, Winston-Salem, North Carolina. It is the first national multidisciplinary conference focusing on critical issues relevant to the safety and cost-effectiveness of office-based surgery in general and dermatologic procedures in particular. This application is requesting partial support for this endeavor that will focus on the scientific understanding of the benefits and risks of office-based surgery. There has been an acute need to address in a scientific manner the information that is available on office-based surgery. This is essential, as understanding the previously unrecognized or under-emphasized benefits and risks of office-based surgery will have important clinical and research implications regarding the patient safety and cost-effectiveness of surgical care at the office-based setting. The Hawthorne Conference is designed to review and integrate the scientific knowledge concerning the benefits, risks and costs of surgery, particularly skin surgery, performed at the office-based setting. It consists of three sessions that focus on: effectiveness of office-based surgery, safety and risks of office-based surgery, and cost benefits of office-based surgery. The specific topics will include the risks of office-based anesthesia, evidence on appropriate anesthesia monitoring for the office, documentation of deaths at office-based dermatologoic surgery procedures, hospital deaths from dermatologic procedures, cost and effectiveness of skin cancer removal in the office-based and hospital-based settings. Key participants will include individuals with a record of expertise in publication in health services research as well as the different clinical physician specialties most related to dermatologic surgery including dermatologists, surgeons, and anesthesiologists. The major conclusion of the conference will be to identify those areas that require additional research as a basis for improving patient safety, quality of care, and physician accountability during the office-based surgery in a cost effective manner